Postoperative analgesic effect of dexmedetomidine in patients undergoing cardiac surgery
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TL;DR: Adding DEX after coronary artery bypass graft decreased both postoperative analgesic requirement and pain score without hemodynamic effects, resulting in a significant decrease in the pain scores in group D compared with group C.
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Abstract: Aim Open heart surgeries are painful procedures that require a large dose of analgesics. The aim of this study was to investigate the effect of postoperative dexmedetomidine (DEX) on the analgesic requirements in postcardiac surgery patients. Settings and design This prospective, randomized, double-blind study was conducted on 60 patients scheduled for elective coronary artery bypass graft surgery at the Cardiothoracic Surgery Unit, Ain Shams University Hospital. Patients and methods this study, group D (n=30) received DEX diluted to 4 μg/ml and infused at a rate of 0.1–0.2 μg/kg/h, whereas group C (n=30) received an equal volume of saline at an infusion rate of 0.1–0.2 μg/kg/h immediately from the end of surgery and postoperatively in the ICU thereafter. Postoperative analgesia was assessed using the Numeric Pain Intensity Scale, and sedation was assessed using the Modified Ramsay Score at T1, T2, T3, T4, T5, and T6 for the first 24 h, as well as postoperative rescue morphine analgesic requirements. Statistical analysis Analysis of data was performed using the Student t-test for independent samples for parametric data and using the χ2-tests for categorical data. Results There was a significant decrease in the pain scores in group D compared with group C (P Conclusion Adding DEX after coronary artery bypass graft decreased both postoperative analgesic requirement and pain score without hemodynamic effects.
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Citations
Comparative study between propofol and dexmedetomidine sedation in reducing delirium after cardiac surgery in elderly patients
Samia Ibrahim Sharaf,Sameh Salem Hefny,Sherif G Anis,Marwa Mamdouh Elfar,Ahmed Abd El-kader Rashed +4 more
TL;DR: Exposure to dexmedetomidine reduced the Incidence, delayed onset, and shortened duration of delirium in elderly patients after cardiac surgery, without difference in length of stay in ICU and hospital length ofStay when compared with propofol.
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References
The Efficacy of Dexmedetomidine Versus Morphine for Postoperative Analgesia After Major Inpatient Surgery
TL;DR: The administration of dexmedetomidine before the completion of major inpatient surgical procedures significantly reduced, by 66%, the early postoperative need for morphine and was associated with a slower HR in the PACU.
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Dexmedetomidine: current role in anesthesia and intensive care
Joana Afonso,Flávio Reis +1 more
TL;DR: Although its wide use is currently in patients of surgical and non-surgical intensive care units, dexmedetomidine seems to have promising future applications in neuroprotection, cardioprotection and renoprotection.
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Dexmedetomidine: a review of its use for sedation in mechanically ventilated patients in an intensive care setting and for procedural sedation.
TL;DR: Intravenous dexmedetomidine provides a further option as a short-term (<24 hours) primary sedative in mechanically ventilated adult patients in an intensive care setting and in non-intubated adult patients prior to and/or during surgical and other procedures.
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The use of dexmedetomidine in pediatric cardiac surgery.
TL;DR: In conclusion, intraoperative dexmedetomidine infusion attenuated the hemodynamic and neuroendocrinal response to surgical trauma and cardiopulmonary bypass in pediatric patients undergoing corrective surgery for congenital heart disease.
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Dexmedetomidine and cardiac protection for non-cardiac surgery: a meta-analysis of randomised controlled trials.
TL;DR: A systematic review of the effects of dexmedetomidine on cardiac outcomes following non-cardiac surgery was conducted by as mentioned in this paper, where prospective, randomised peri-operative studies were included in the meta-analysis.
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